7 research outputs found
Analysis of X-knife and surgery in treatment of arteriovenous malformation of brain
Background: The goal of treatment in arteriovenous malformation (AVM)
is total obliteration of the AVM, restoration of normal cerebral
function, and preservation of life and neurological function. Aim: To
analyze the results of X-knife and surgery for AVM of the brain. The
endpoints for success or failure were as follows: success was defined
as angiographic obliteration and failure as residual lesion, requiring
retreatment, or death due to hemorrhage from the AVM. Materials and
Methods: From May 2002 to May 2007, 54 patients were enrolled for this
study. Grade I AVM was seen in 9%, grade II in 43%, grade III in 26%,
grade IV in 9%, and grade V in 13%. Thirty-eight patients were treated
by microsurgical resection out of which Grade I was seen in 5 patients,
Grade II was seen in 17 patients, Grade III was seen in 9 patients and
Grade V was seen in 7 patients. Rest of the sixteen patients were
treated by linear accelerator radiosurgery out of which Grade II was
seen in 6 patients, Grade III was seen in 5 patients and Grade IV was
seen in 5 patients. The follow up was in range of 3-63 months. In
follow up, digital subtraction angiography/ magnetic resonance
angiography (DSA/MRA) was performed 3 months after surgery and 1 year
and 2 years after stereotactic radiosurgery (SRS). Results: Among the
patients treated with X-knife, 12/16 (75%) had proven angiographic
obliteration. Complications were seen in 4/16 (25%) patients. Among the
patients treated with microsurgical resection, 23/38 (61%) had proven
angiographic obliteration. Complications (both intraoperative and
postoperative) were seen in 19/38 (50%) patients. Conclusions:
Sixty-one percent of patients were candidates for surgical resection.
X-knife is a good modality of treatment for a low-grade AVM situated in
eloquent areas of the brain and also for high-grade AVMs, when the
surgical risk and morbidity is high
Prospective study of sequential volumetric changes of parotid gland in early oropharyngeal carcinoma patients treated by intensity-modulated radiation therapy: An institutional experience
Aims and Objectives: During course of radiation therapy, anatomical variations occur risking overdose of parotid gland. We tried to quantify volume of parotid gland and mean dose to parotid gland after every 10 fractions (#). Materials and Methods: We conducted the prospective study from July 2016 to May 2017 in 25 patients of early-stage oropharyngeal carcinoma. Patients had Karnofsy Performance Score of 80–100, median age was 54 years, and 18 patients were males. Patients were planned with intensity-modulated radiation therapy planning with dose as 66 Gy/30# to planning target volume (PTV) including primary and 54 Gy/30# to PTV-nodal including elective neck irradiation. After each 10#, replanning was done, and variations in parotid volume were studied including Dmean(mean dose to parotids) and D50(the dose delivered to 50% of volume). Other tumor characteristic like PTV of primary was also assessed and minimum PTV volume covered by 95% isodose line was kept as 95%. Results: Average parotid volumes decreased by the mean value of 10% and 6% for the left and right parotids, respectively, and PTV of primary target decreased by mean of 13%. The difference in Dmeandoses to parotid glands was 32% and 42% and difference in D50dose was 30% and 35% on the left and right side, respectively. Conclusions: The parotid volumes differ considerably during adaptive planning done after every ten fractions. These differences in parotid volumes and doses received to parotid glands play a significant role in the risk of xerostomia observed during later follow-up
High risk and poor prognostic features determining aggressiveness of disease in post operative locally advanced cases of oral cavity carcinoma: an institutional experience
Locally advanced oral cavity cancer is managed in multidisciplinary setting including surgery followed by postoperative radiotherapy (PORT) and chemotherapy. We also follow the same protocol however during the active treatment only our patients had recurrence of disease. We enrolled 16 cases of locally advanced oral cavity cancer seen from September to November 2015 at our Radiation Oncology department. Most common presentation is age group of 31-40 years and 14 cases were males out of 16. The pattern of presentation included cases as 9 carcinoma tongue, 5 carcinoma buccal mucosa, 1 carcinoma angle of mouth and 1 carcinoma of lower alveolus. All these patients were operated and referred for PORT. The dose of PORT planned was 60 Gy/30# for 6 weeks along with concurrent cisplatin 30mg/m2 weekly. All these patients by the mid of the treatment developed nodal recurrence confirmed on Biopsy. When the high risk factors were extrapolated it was found that depth was more than 1 cm, base of resection (BOR) was also close all being <0.5 cm and margins being very close the cut off being 0.3 cm. All these patients had their PORT started after 7 weeks of surgery. Age <45 years, depth >1 cm, BOR <0.5 cm and close margins with cut off 0.3 cm, perinodal extension or otherwise presence of perineural invasion were poor prognosis features determining aggressiveness of disease. This study gave an impetus to explore more in such type of poor prognosis patients and we look forward for more insight
Analysis of X-knife and surgery in treatment of arteriovenous malformation of brain
Background: The goal of treatment in arteriovenous malformation (AVM)
is total obliteration of the AVM, restoration of normal cerebral
function, and preservation of life and neurological function. Aim: To
analyze the results of X-knife and surgery for AVM of the brain. The
endpoints for success or failure were as follows: success was defined
as angiographic obliteration and failure as residual lesion, requiring
retreatment, or death due to hemorrhage from the AVM. Materials and
Methods: From May 2002 to May 2007, 54 patients were enrolled for this
study. Grade I AVM was seen in 9%, grade II in 43%, grade III in 26%,
grade IV in 9%, and grade V in 13%. Thirty-eight patients were treated
by microsurgical resection out of which Grade I was seen in 5 patients,
Grade II was seen in 17 patients, Grade III was seen in 9 patients and
Grade V was seen in 7 patients. Rest of the sixteen patients were
treated by linear accelerator radiosurgery out of which Grade II was
seen in 6 patients, Grade III was seen in 5 patients and Grade IV was
seen in 5 patients. The follow up was in range of 3-63 months. In
follow up, digital subtraction angiography/ magnetic resonance
angiography (DSA/MRA) was performed 3 months after surgery and 1 year
and 2 years after stereotactic radiosurgery (SRS). Results: Among the
patients treated with X-knife, 12/16 (75%) had proven angiographic
obliteration. Complications were seen in 4/16 (25%) patients. Among the
patients treated with microsurgical resection, 23/38 (61%) had proven
angiographic obliteration. Complications (both intraoperative and
postoperative) were seen in 19/38 (50%) patients. Conclusions:
Sixty-one percent of patients were candidates for surgical resection.
X-knife is a good modality of treatment for a low-grade AVM situated in
eloquent areas of the brain and also for high-grade AVMs, when the
surgical risk and morbidity is high